Speculum instrument and isolated light means therefor

ABSTRACT

A speculum instrument with improved lighting means therefore is disclosed wherein the speculum barrel, which may be a single use disposable material, tapers to become increasingly larger at its proximal end. A smaller cylindrical sleeve member having a light transmitting flange or wall at one end, has the flange affixed into the larger proximal end of the barrel with the sleeve extending therefrom, to define an annular contamination isolated area with the flange directed towards the distal end of the barrel. A handle member containing a light source releasably engages the speculum barrel and provides lamp means in the isolated area to direct light through the barrel. An obturator in the barrel may be withdrawn through the sleeve.

I United States Patent 1 3,675,641 Fiore 51 July 11, 1972 541 SPECULUMINSTRUMENT AND FOREIGN PATENTS OR APPLICATIONS ISOLATED LIGHT MEANSmREFOR 14,503 1906 Great Britain l28l6 [72] Inventor: John M. Flore,Troy. NY.

I Primary Examiner-Lucie H. Laudenslager [73] Assignee. lilo-Analyticallaboratories, Inc. Lichieno [22] Filed: Nov. 21, 1969 57 BS I R [2| 1Appl No.: 878,655 I 1 A ACT A speculum instrument with improved lightingmeans therefore is disclosed wherein the speculum barrel, which may be asingle use dis ble material tapers to become increasingly [58] H I s 9I0 I I larger at its proximal end. A smaller cylindrical sleeve memberhaving a light transmitting flange or wall at one end. has the flangeaffixed into the larger proximal end of the barrel with [56] Referencescued the sleeve extending therefrom, to define an annular con- UNITEDSTATES PATENTS tamination isolated area with the flange directed towardsthe distal end of the barrel. A handle member containing a light k450i?et a]. ..l28/6 50m, releasably engages he spcculum barrel and pmvides3071l29 H963 28/6 lamp means in the isolated area to direct lightthrough the barrel. An obturator in the barrel may be withdrawn throughthe sleeve.

13 Clalrm, HM-swing figures PATENTEDJUL 1 I 1972 SHEET 10F 2 invent-0rJob/7 H'are J5 ml} 42% ZQ I'S 7%0r/7ey SPECULUM INSTRUMENT AND ISOLATFJ)LIGHT MEANS THEREFOR BACKGROUND OF INVENTION 1. Field of Invention Thisinvention relates to speculum instruments generally, and moreparticularly to proctoscopic speculums having enclosed, contaminationisolated light directing means at the proximal end of the barrel throughwhich an obturator may be withdrawn.

2. Description of Prior Art Speculum instruments may be defined broadlyas instruments adaptable for insertion into a body opening, human oranimal, in order to medically observe or treat an inner portion. Inparticular rectal speculums, defined generally as proctoscopicspeculums, including anoscopes and sigmoidoscopes, have becomeincreasingly important in routine and preventative medical examinationsas well as for medical treatment. More specifically, there is increaseduse of sigmoidoscopes for examination and treatment of the upper reachesof the colon, and disposable sigmoidoscopes for this purpose are verydesirable. However, a notable limitation of these proctoscopic devicessuch as sigmoidoscopes relates to the lack of optimum lighting meansemployed therewidi.

In the use of medical speculum devices generally a light source isdesirable to increase the accuracy of more precise types of diagnosticexaminations, and also to facilitate various treatment processes carriedon through the device. Ordinarily such a light source may be one whichis generally external to the instrument, or one which is attachedthereto at the proximal end, and arranged in either instance, to havelight directed into or through the speculum. These and other similararrangements suffice for short-length speculum devices where relativelylow lighting power of the light source is sufficient. However, in thelonger speculum instruments such as a sigmoidoscope, where the effectivelength may be on the order of 25 centimeters or more, and where theinstrument is of necessity an enclosing cylinder, more lighting power isnecessary because of distance involved and the nature of the parts to beexamined. Because of this notable requirement, it is usual designpractice in sigmoidoscopes to have the light source placed inside theinstrument and adjacent the distal end thereof. In this position,however, the light source is subject to contamination from contact withthe patient directly or indirectly so that without means for maintainingthe light source in a sterile or sanitary condition, impending reuse forother patients without intervening cleansing is prohibited. Therefore,the highly desirable disposability concept of the sigmoidoscope islimited by its being combined and employed with a lighting means whichis not disposable or immediately reusable.

Another problem associated with the above described and other lightingmeans incorporated with the speculum, relates to the requirement of easeof assembly and detachability of the lighting means to the speculum sothat the speculum may be of a single use disposable type and thelighting means readily and easily detached therefrom without requisiteskill. A further problem with proctoscopic devices employing anobturator relates to some provision for removing the obturator while thelighting means is in position, without changing the circumferentialconfiguration of the sigmoidoscope or obturator, to minimize assemblysteps prior to use. Reference is made to US. Pat. No. 3,373,736-Fiore etal. and British Pat. Nos. 1,034,222; 1,947,140; 1,048,600 and l,08l,849for further description of a disposable sigmoidoscope and lighting meanstherefore.

OBJECTS OF THE INVENTION Accordingly, it is an object of this inventionto provide an improved speculum instrument and lighting means therefore.

It is another object of this invention to provide an improved single usedisposable proctoscopic instrument with separate isolated lighting meanstherefore.

It is a further object of this invention to provide an improved singleuse disposable proctoscopic instrument with separate isolated lightingmeans incorporated at the proximal end thereof.

It is a still further object of this invention to provide an improvedsingle use disposable sigmoidoscope having a separable lighting meansincorporated in the proximal end thereof in enclosed, protected, andcontamination isolation relationship thereto.

It is yet another object of this invention to provide an improved singleuse disposable sigmoidosoopic instrument with separate protectivelighting means in the proximal end thereof through which an obturatormay be withdrawn.

It is another object of this invention to provide a single usedisposable sigmoidoscope where the barrel tapers from proximal to distalend to provide a walled area behind which lighting means are isolated,and through which the obturator may be withdrawn.

It is another object of this invention to provide an improved single usedisposable sigrnoidoscopic barrel which tapers to provide a largerproximal end in which a separate annular walled insert defines aprotected lighting means area directly viewable from the distal end, andthrough which an obturator may be withdrawn.

BRIEF DESCRIPTION This invention in one of its preferred forms includesa single use disposable sigmoidoscopic barrel having a tapered bore toprovide an enlarged proximal end. A smaller sleeve member having a clearplastic flange is concentrically attached to the enlarged end of thebarrel with the flange providing an annular window radially within theenlarged end of the barrel and the sleeve projecting axially therefrom.A handle lighting unit is fitted coaxially over the sleeve so that lightfrom a lamp therein is directed through the annular window and down thebarrel. The sleeve aperture is slightly larger than the opening of thedistal end of the barrel so that an obturator may be withdrawn throughthe sleeve, and the sleeve protects the lighting means fromcontamination.

BRIEF DESCRIPTION OF THE DRAWINGS This invention will be betterunderstood when taken in connection with the following description anddrawings in which FIG. I is a side elevational view of one preferredembodiment of this invention.

FIG. 2 is an illustration of a separate sleeve means for this invention.

FIG. 3 is a cross-section and axial view from the proximal end of theembodiment of FIG. 1 along line 33.

FIG. 4 is a cross-section and axial view from the distal end of theembodiment of FIG. 1 along line 44.

FIG. 5 is an illustration of a detachable handle and light assembly forFIG. 1 along line 5-5.

FIG. 6 is a side elevational view of a modified barrel member of FIG. 1.

FIG. 7 is a side elevational view of a modified proximal end arrangementof the FIG. 1 embodiment.

DESCRIPTION OF PREFERRED EMBODIMENTS Referring now to FIG. 1 thespeculum instrument I0 is preferably a proctoscopic instrument, which inan exemplary embodiment, is a sigmoidoscope. Instrument I0 is bestdescribed as incorporating two separable structures, e.g. a barrelmember 11 which is preferably a single use disposable item, and a handlelighting unit 12 which is usually of a permanent or semi-permanentnature.

Barrel member 11 may be expeditiously manufactured from a material whichis readily and economically single use disposable. The material must beone which is ordinarily sterilizable and which retains sufficientrigidity without brittleness. In one preferred form of this inventionthe material for barrel 1] may be a moldable and extrudable syntheticresin such as linear polyethylene and polypropylene as noted in theaforementioned US. patent and the applications referred to therein.

It is a salient and foremost feature of this invention that barrel Itincludes a tapering or gradual enlargement preferably from the distalend 13 to the proximal end 14 thereof. A tapered barrel is one that isgenerally frusto conical or flared over its effective length, i.e., thelength of barrel 11 which is inserted in a body opening. This taperingor flaring provides an opening or diameter of the enlarged proximal end14 which is significantly larger than the distal end 13 opening. it ispreferred that the taper retain the circular cross-section of barrel 1 land that the taper commence at or very close to the distal end 13 ofbarrel 11. The defined taper may be linear, as frusto conical, or it maybe curvilinear, such as being flared or hell mouthed, i.e. inwardlybowing, or slightly convex or domed, i.e. outwardly bowing. Under someconditions the tapering may commence at a point between the proximal anddistal ends of barrel 11. The proximal end of barrel 1 1 may include amore abruptly flaring or radial part 15, which may also extend sharplyradially to define an end shield or hand guard 16.

In order to define an isolated and protected light position or chamber,an end sleeve member 17 is positioned adjacent flare part 16 of barrelll and suitably attached thereto. Ordinarily, sleeve member 17 isconsidered a part of barrel member 11. As illustrated in FIG. 2, thesleeve member 17, in one preferred embodiment includes a generallycylindrical section 18 and a flange or wall section 19. In one form ofthis invention, flange section 19 is press fitted into a lockingshoulder 20 on flaring part [6 of barrel 1]. A number of other suitablejoining means may be gainfully employed to secure flange 19 to flarepart 16. For example, direct locking means may take the form of matingscrew threads on each part, a snap fit, or a suitable interlock.Indirect means may take the form of cementing of the parts or a pressfit of the parts. Alternatively sleeve 17 may be molded as an integralpart of barrel ll, or may in fact be a separate device attached tohandle unit 12.

Because of the defined taper of barrel 11, the flange or wall l9 definesan inwardly projecting annular window wall, which in combination withcylindrical section 18 defines an area remote from or isolated from themain channel through barrel 1 1. Flange wall 19 projecting inwardly, asit does, has an unobstructed view of the distal end opening 13 of barrel11, and for this reason flange 19 is made of a transparent material suchas a clear synthetic resin, or has suitable clear sections or lensestherein. Therefore, a lighting means in handle lighting unit 12, andbehind wall 19, will transmit light down barrel 11 to the distal end.Cylindrical section 18, however, is of limited transparency andpreferably non-transparent, either because of the material from which itis produced, or by reason of suitable coloring or coatings.

An obturator assembly (shown in dashed line outline) includes a smoothovate tip portion 2] whose maximum diameter closely approximates theinternal diameter of the smooth rounded distal end opening 13 of barrelII. A stem means 22 extends from the tip portion 21 through barrel 11 toproject from the proximal end thereof. An obturator is employedprimarily to facilitate insertion of a speculum or barrel ll into a bodyorifice such as the rectum, and this use is an accepted and establishedpractice. Afier insertion of the barrel a short distance into therectum, just beyond the sphincter muscle, the obturator is withdrawn.Thereafter, in accordance with present well known sigmoidoscopes, alighting means would be inserted into barrel 11, such as for example thelighting means of US. Pat. Nos. 3,373,736 or 3,032,03 I.

In the noted present practice the lighting means in the barrel isexposed to contamination by being near the open distal end and becausewithdrawal of the obturator ordinarily contaminates the inside of thebarrel. Additionally when certain instruments are passed into thebarrel, or where swabbing practices take place, the inside of the barrelas well as the lighting means therein are further contaminated.Accordingly, the lighting means must be of a stringent design so as tobe of a readily sterilizable or sanitizable nature, or suitablyprotected. There are a number of problems associated with each facetnoted. Sterilization of the lighting means or the barrel is anundesirable and uneconomical process which is subject to error. Theprotective sleeve and other protective arrangements are usuallycumbersome and lacking in handling as well as lighting efficiency.

It has been discovered that the noted problems are significantlyovercome by the use of tapered barrel 11, as illustrated in FIG. 1,which, in combination with a sleeve means 17 provides for obturatorremoval with lighting means remaining in position and not beingcontaminated. For example, in the illustrated arrangement of FIG. 1,sleeve 17 has an internal bore diameter larger than the maximum diameterof distal end opening 13 so that an obturator tip may easily passtherethrough. Suitable guiding ramps may be provided as extensions onsleeve 17 into barrel 11 or as raised surfaces on the inner surface ofbarrel 1] to facilitate withdrawal of the obturator. Contact of sleeve17 with obturator tip 2! is not a problem since sleeve 17 is disposed ofwith barrel 1 l.

The handle lighting unit 12 comprises generally, a handle part 23 and alighting head 24 which connects to barrel 1 l and contains the lamps 25.The lighting head 24 comprises an annular part 26 having a distal endfacing recess 27 therein. Recess 27 which may be annular or suitablycompartmentalized is next adjacent annular flange l9, and closed off bycylinder 18 so as to be an isolated chamber containing therein aplurality of usually equally circumferentially spaced lamp means 25. Asillustrated in FIG. 1 four such lamp means are utilized, and while asingle lamp may provide some degree of lighting, two or more arepreferred. A single ring or pair of half ring lamps may also be used togood advantage. The important concept, however, is to have the lampmeans not only isolated and remote from the main channel of barrel 10but yet to remain in exposed or viewing relationship to the distal endof barrel 11. By this means the main channel of barrel ll remains openfor the unobstructed passage of various instruments, swabs, and theobturator without danger of contamination of the lighting means.

Light transmission may be further increased by the use of pre-focusedlamps, lamps with an integral mirror surface, or by the use of focussingreflectors 28 in recess 27 of lighting head 24. The combination of anannular transparent flange wall l9, lamps 25, and reflectors 28 may besuitably integrated in function and effect to focus and direct asubstantial amount of light at the center line of the distal end ofbarrel ll. This invention may also provide for a high intensity lightsource in handle light unit 12 which is merely reflected by a suitablemirror or other light directing and amplifying means in the space orrecess 27 presently occupied by lamps 25.

Light transmission down barrel 1] and its quantity and direction isimportant to the practice of sigmoidoscopic examination. The lightingmeans as described is advantageous because it pemlits the use of plurallamps, or a single lamp in ring form, with greatly increased wattage andmore distal end light, as compared to a single lamp in barrel ll. and inspite of the more rearward location of lamps 25.

The effectiveness of the lighting means is increased by avoiding glarein barrel 11 and, for this reason the inner surface of barrel 11 may betreated, colored, or formed so that glare is reduced, and effectivelight transmission increased.

The annular flange 19 has an effective light transmitting height,measured generally from the upper surface of cylindrical section 18 tothe inner surface of the end of the taper of barrel 1], which isdependent on the amount of taper in barrel 11. While the taper may varyto a considerable degree, an effective light transmitting height need beno more than from about one-sixteenth to about one-eighth inch. it ismost desirable to concentrate the lamp means 25 as near to the centerline of barrel 11 as expedient in order to provide as much uninterruptedlight transmitting down barrel II, and for this reason excessive taperof barrel I1 is not necessary for lighting purposes.

The lighting head 24 is provided with means to releaseably secure it tobarrel ll. Releaseable securing is intended to mean those attaching oraffixing devices not ordinarily intended to be of a pennanent nature,and are intended to be a part of or utilized in the operation of thedevice. Quick disconnects, latches and the like which play a significantrole in one cycle use are further examples of releaseable securingdevices. One example of a convenient releaseable securing means isillustrated in FIG. 1 by the mating screw thread or camrning means 29 onannular part 26 as well as on cylindrical extension 18. Other lockingdevices including snap acting, detent and such interlocking devices mayalso be utilized with good advantage not only between the annular part26 and cylindrical extension 18, but also in lieu thereof, between ortogether with annular part 26 and radial part 16 of barrel 1 I.

In some instances it may be desirable to include a biasing or springacting interlock between lighting head 24 and barrel ll. Such springloading releases may forcibly eject the barrel II from lighting unit 12by operation of a release mechanism by the medical practitioner. Theforcible ejection as a practical matter need only move the barrelassembly a fraction of an inch to be effective. One such eject mechanismis disclosed and claimed in combination with a vaginal speculum incopending application Ser. No. 529,444Fiore, now U.S. Pat. No.3,532,088.

The lighting head 24 includes a handle unit extension 23 which may beseparably attached or, ordinarily an integral part thereof. Handle part23 may be of various configurations and primarily is of a generallycylindrical shape for ease in handling as well as to serve as aconveniently shaped housing for a power unit such as a battery 30 (shownin dotted lines in FIG. I preferably of the rechargeable type asdescribed in the above noted US. patent. The battery or batteries 30 inhandle part 23 may be suitably connected to a combined on-off-rheostatelement 31 and then to lamps so that the medical practitioner mayexercise light control when needed or desirable. Battery may be suitablyrecharged by inserting the handle part 23 in a recharger for rechargingas known in the art. Alternatively, battery 30 may be removed fromhandle part 23 by removing an end cover and placing the battery 30itself in a recharger as well known in the art. Provision may also bemade to provide an electric extension lead connected to lamps 25, or toa transformer and then to lamps 25, to obtain electrical power from adomestic or commercial power source or outlet.

It is desirable, in the practice of sigmoidoscope examinations, to havea suitable closure member and lens assembly at the proximal end of asigmoidoscope as well as at the same end of a host of other speculuminstruments. Accordingly, in the present invention a suitable end capunit 32 is affixed to the lighting head 24 and may be hinged as a rotaryslide opening or a gate hinge type opening, as is known in the art.Altematively the end cap unit may be a separate eyepiece which issuitably attached as desired. End cap unit 32 is usually provided withan optical lens 33 to facilitate examination. As such, the lens 33 maybe a magnifying lens, or lens assembly including if desirable suitableoptical adjusting means for focussing, for example.

In some instance either a positive air pressure or a negative airpressure (from room conditions) is desirable in connection withsigmoidoscopy. For example, a negative pressure is generated by gentlesuction to remove gases, smoke from cauterization and the like. Apositive pressure may be employed to slightly distend certain areas ofthe colon to facilitate examination. Both suction and pressure isapplied through a nipple or conduit 34 which projects from lighting head21 and communicates to the interior of barrel I] through an appropriateopening or slot 35 (not shown) in cylindrical section l8.

Sealing means are employed to retain pressure or suction at the proximalend of the instrument I0. For example, a seal is provided between radialpart 16 of barrel 11 and the adjacent face of annular lighting head 24.Such a seal is preferably in the form of a ring type gasket 36 retainedin a seal cavity 37 in the face of lighting head 24. Ring gasket 36 maybe of a number of configurations and materials including relatively sofiO-rings of medically serviceable materials. In one embodiment of thisinvention ring seal 36 is of a neoprene material and U-shaped to beexpanded, by air pressure, into contact with opposed walls. A furtherring seal such as a relatively soft O-ring 38 is employed between endcap unit 26 and lighting head 24. Ring seal 38 may also be disposed in asuitable recess 39 in lighting head 24. Seal 36 is compressed byengagement of lighting head 24 to the radial flange 16 in combinationwith screw threads 29. Seal 38 may be compressed by means of a suitablecam clip 40 engaging cam groove 41 in lighting head 24. Seals 36 and 38effectively close ofi' the proximal end of the speculum instrument sothat gentle pressure is exerted through the distal end of barrel ll.During examination certain gaseous results of treatment are also removedby gentle suction.

The radial flange part 16 of barrel 11 may serve as a hand guard unit asemployed with sigmoidoscopes generally and may be further radiallyextended, and also curve towards the proximal end, for this purpose.Alternately, a separate hand guard may be attached to the barrel 11 ormolded integrally therewith.

The speculum instrument 10 of this invention is readily adaptable foruse as other speculum type instruments particularly proctoscopes andanoscopes generally. In this connection barrel 11 may be made shorter toserve as an anoscope, for example, or of smaller diameter for smallerbody openings. The handle unit 12 is further adaptable to a wide varietyof uses in medical practice where a good source of light is needed. Assuch, it may be gainfully employed with other medical instruments,disposable or otherwise, which may be adaptable thereto including, forexample, opthalmoscopes and otoscopes.

FIG. 3 illustrates a view of the speculum 10 from the proximal endthereof along line 3-3. In FIG. 3 the lamps are shown in phantom toillustrate their position adjacent window member 19. The diameterdifi'erence between member I9 and barrel 11 is correlated to thedifference in diameters of opening 13 and barrel II. This differencewhich represents the taper of barrel 11 provides the direct exposure ofa portion of lamp 25 to distal end opening 13. While four lamps 25 areshown, the number may be suitably varied for example by the use of twoor three lamps. In some instances varying degrees of lighting mightrequire a maximum of four lamps, and other instances a less number oflamps. The on-off switch 31 may be suitably provided with a stepswitching means to control the number of lamps energized.

FIG. 4 illustrates a view somewhat opposite to that of F IG. 3. The FIG.4 view is from the distal end opening 13 along line 4-4 of FIG. 1 andassumes an angle view from the center line of FIG. 1. Accordingly thatportion of flange window unit 19 which is directly exposed to distal endopening 13 is clearly shown, exaggerated slightly to show detail.

FIG. 5 illustrates the handle unit 12 of this invention separate frombarrel 1] and readily adaptable for insertion into a battery chargingunit or other storage device. FIG. 5 also illustrates the adaptabilityof handle unit 12 as a general light source alone or with otherinstruments.

The foregoing describes one complete embodiment of this invention. Otherembodiments and modifications may also be provided, the importantfeature being the taper of the barrel to provide an isolated orprotected lighting area without any significant change in the operation,effectiveness and use of the instrument. However, barrel 11 may betapered externally and/or internally to provide this feature. In FIG. 1the barrel may be described as having an external taper to provide theenlarged proximal end. lntemal tapering may also provide an enlargedproximal end, as illustrated in FIG. 6.

In FIG. 6 barrel 38' is similar to barrel 1! of FIG. 1 and includes thesame general dimension of the proximal end as barrel l 1. Barrel 38includes an internal taper which is provided by a wall thickness 39which increases towards the distal end. This thick wall section at thedistal end serves as a support 40 for the obturator 2!. To accommodatethe internal taper the obturator 21' may be slightly smaller thanobturator 21 of FIG. 1 and/or the proximal end dimensions may besomewhat larger. The internal taper may not be required over theeffective length of the barrel but only need be utilized close to thedistal end with the remaining wall lengths being of relatively constantthickness.

The combination of tapers, both internally and externally, may be anadvantageous compromise because a slight taper is usually employed tofacilitate removal of a barrel from an injection mold process, when sucha process is employed. This pre-taper may be incorporated in thisinvention.

A further modification of this invention is illustrated in FIG. 7. FIG.7 comprises a sectional and top view of a modified lighting head 41similar to lighting head 24 of FIG. 1, and flare part 42 of barrel 11',similar to flared part of FIG. 1. In FIG. 7, flared part 42 includes aflange portion 43, and a projecting portion 44 which projects into andengages lighting head 4]. Lighting head 41 includes a recess 45 intowhich projecting portion 44 is positioned and retained. The retainingmeans includes the combination of a circumferential groove 46 inprojecting portion 44 and a plurality of circumferentially spaced springbiased balls commonly known as ball detent devices, one of which isshown schematically at 47.

Lighting head 4] also includes a pair of oppositely disposed bell crankor angle members 48 and 49 which are pivoted at 50 and SI so that thearms 52 and 53 engage the free end of projecting portion 44.

As illustrated the application of a depressing force on the exposed armsof angle members 48 and 49 will cause a pivoting action so that arms 52and 53 bear against projection 44 and move the barrel assembly axiallyoutwardly from lighting head 41. When the free edge of projectingportion 44 passes by the spring biased balls of detent devices 47, acamming action occurs to positively release and eject the barrel fromthe lighting head. Various other positive ejection, electrical ormechanical means may be employed to cause removal of the barrel assemblyfrom the lighting head without the necessity of the practitionertouching a potentially contaminated barrel as sembly. This releasingmechanism accomplishes a positive release and automatic ejectingmechanism which greatly expedites the use of this invention.

The flare part 42 of barrel II also provides direct lighting through thedistal end of the barrel in that the circular row of lamps 58 are atleast partly exposed to the distal end, as illustrated in FIG. 3, forexample. Ordinarily a straight line may be drawn from a lamp through thedistal end of the barrel without crossing any barrel structure whichwould obstruct light passage.

While other modifications of this invention and variations of apparatusmay be employed within the scope of this invention and have not beendescribed or illustrated, the invention is intended to include all suchmodifications as may ordinarily be embraced within the following claims.

What I claim as new is:

I. A speculum instrument comprising in combination a. a barrel memberhaving a proximal and distal end and adapted for insertion into a bodyopening,

b. a handle unit releaseably secured to said barrel member at theproximal end thereof,

c. said barrel member tapering from a smaller distal end to a largerdimension at the proximal end thereof,

d. a sleeve member at said proximal end of said barrel and defining anaperture through the proximal end of said barrel of significantly lessdiameter than said larger barrel dimension,

e. radially inwardly projecting light transmitting wall means betweenand en aging said sleeve member and said barrel for directing li t intothe bore of said barrel and through said distal end and f. light meansin said handle unit adapted to pass light through said lighttransmitting means.

2. The invention as recited in claim 1 wherein said sleeve member is aseparate member attached to said larger proximal end of said barrelmember.

3. The invention as recited in claim I wherein said sleeve memberincludes a flange window section with the said flange window sectionbeing said light transmitting means.

4. The invention as recited in claim 1 wherein said sleeve member andsaid barrel member are of a single use disposable synthetic resinmaterial.

5. The invention as recited in claim 3 wherein said flange section isattached to said larger proximal end of said barrel member and saidsleeve section extends therefrom.

6. The invention as recited in claim 5 wherein the inside diameter ofsaid sleeve member is slightly larger than the inside diameter of saidbarrel distal end so that an obturator in said distal end may bewithdrawn through said sleeve member.

7. The invention as recited in claim 6 wherein said light meanscomprises a plurality of lamps positioned in said handle unit andadjacent said flange section to direct light down said barrel member.

8. The invention as recited in claim 7 wherein said handle unit isreleaseably secured to said sleeve member.

9. The invention as recited in claim 8 wherein said speculum instrumentis a sigmoidoscope.

10. The invention as recited in claim 9 wherein the effective length ofsaid barrel member is of a frusto conical configura tlon.

II. The invention as recited in claim 10 wherein said barrel memberincludes an inner taper extending over a significant portion of itseffective length.

12. The invention as recited in claim 10 wherein said barrel memberincludes an external taper extending over a significant portion of itseffective length.

13. The invention as recited in claim 1 wherein said barrel memberincludes an outwardly flared proximal end portion, and an axiallyprojecting portion on said flared portion adapted to be engaged by saidhandle unit.

1. A speculum instrument comprising in combination a. a barrel memberhaving a proximal and distal end and adapted for insertion into a bodyopening, b. a handle unit releaseably secured to said barrel member atthe proximal end thereof, c. said barrel member tapering from a smallerdistal end to a larger dimension at the proximal end thereof, d. asleeve member at said proximal end of said barrel and defining anaperture through the proximal end of said barrel of significantly lessdiameter than said larger barrel dimension, e. radially inwardlyprojecting light transmitting wall means between and engaging saidsleeve member and said barrel for directing light into the bore of saidbarrel and through said distal end and f. light means in said handleunit adapted to pass light through said light transmitting means.
 2. Theinvention as recited in claim 1 wherein said sleeve member is a separatemember attached to said larger proximal end of said barrel member. 3.The invention as recited in claim 1 wherein said sleeve member includesa flange window section with the said flange window section being saidlight transmitting means.
 4. The invention as recited in claim 1 whereinsaid sleeve member and said barrel member are of a single use disposablesynthetic resin material.
 5. The invention as recited in claim 3 whereinsaid flange section is attached to said larger proximal end of saidbarrel member and said sleeve section extends therefrom.
 6. Theinvention as recited in claim 5 wherein the inside diameter of saidsleeve member is slightly larger than the inside diameter of said barreldistal end so that an obturator in said distal end may be withdrawnthrough said sleeve member.
 7. The invention as recited in claim 6wherein said light means comprises a plurality of lamps positioned insaid handle unit and adjacent said flange section to direct light downsaid barrel member.
 8. The invention as recited in claim 7 wherein saidhandle unit is releaseably secured to said sleeve member.
 9. Theinvention as recited in claim 8 wherein said speculum instrument is asigmoidoscope.
 10. The invention as recited in claim 9 wherein theeffective length of said barrel member is of a frusto conicalconfiguration.
 11. The invention as recited in claim 10 wherein saidbarrel member includes an inner taper extending over a significantportion of its effective length.
 12. The invention as recited in claim10 wherein said barrel member includes an external taper extending overa significant portion of its effective length.
 13. The invention asrecited in claim 1 wherein said barrel member includes an outwardlyflared proximal end portion, and an axially projecting portion on saidflared portion adapted to be engaged by said handle unit.